Title | Plasma total homocysteine levels and cranial magnetic resonance imaging findings in elderly persons: the Cardiovascular Health Study. |
Publication Type | Journal Article |
Year of Publication | 2004 |
Authors | Longstreth, WT, Katz, R, Olson, J, Bernick, C, J Carr, J, M Malinow, R, Hess, DL, Cushman, M, Schwartz, SM |
Journal | Arch Neurol |
Volume | 61 |
Issue | 1 |
Pagination | 67-72 |
Date Published | 2004 Jan |
ISSN | 0003-9942 |
Keywords | Aged, Aging, Brain, Brain Infarction, Female, Homocysteine, Humans, Magnetic Resonance Imaging, Male, Odds Ratio, Radiography, Risk Factors |
Abstract | <p><b>BACKGROUND: </b>An elevated plasma total homocysteine (tHcy) level is associated with an increased risk of vascular disease. Some studies have shown associations between tHcy level and small-vessel disease of the brain on magnetic resonance imaging (MRI).</p><p><b>DESIGN: </b>In the Cardiovascular Health Study, 622 elderly participants without a history of transient ischemic attack or stroke had results for tHcy level and cranial MRI. We sought associations between tHcy level and MRI findings of ventricular grade, sulcal grade, white matter grade, and infarcts. We controlled for other factors, including levels of creatinine, folate, and vitamins B(6) and B(12) and methylenetetrahydrofolate reductase genotype.</p><p><b>RESULTS: </b>After controlling for age and sex, tHcy level was not associated with the individual MRI findings. Further adjustments for other factors and other blood tests had little effect on these findings. The only significant finding was a linear trend across quintiles of tHcy level and a pattern of MRI findings combining infarcts and high white matter grade. The linear trend remained significant after controlling for other risk factors and atherosclerotic markers (top quintile vs bottom quintile odds ratio, 3.3; 95% confidence interval, 0.96-11.20; P =.04 for linear trend) but was slightly diminished after further controlling for creatinine, folate, and vitamins B(6) and B(12) (odds ratio, 3.2; 95% confidence interval, 0.81-13.10; P =.07 for linear trend).</p><p><b>CONCLUSION: </b>We were unable to confirm the results of previous studies with respect to tHcy level and individual MRI findings, although an association was seen for an MRI pattern combining infarcts and high white matter grade.</p> |
DOI | 10.1001/archneur.61.1.67 |
Alternate Journal | Arch Neurol |
PubMed ID | 14732622 |
Grant List | N01 HC 85086 / HC / NHLBI NIH HHS / United States N01 HC 35129 / HC / NHLBI NIH HHS / United States N01 HC 85079 / HC / NHLBI NIH HHS / United States R01 HL 5471 / HL / NHLBI NIH HHS / United States N01 HC 15103 / HC / NHLBI NIH HHS / United States R01 HL054711-03 / HL / NHLBI NIH HHS / United States |